| NPI | 1841797610 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV DO3111)  | 
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CO DR.0066283)  | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-09 | 
| Last Update Date | 2024-08-22 |