| NPI | 1851730774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME127734) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 56118) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NJ TRN18877) | |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2024-07-16 |