| NPI | 1831630193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD474330) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125070602) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-19 |
| Last Update Date | 2023-11-03 |