| NPI | 1851824262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 305329) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: RI MD17194) |
| 207P00000X Emergency Medicine (Licence: CT 69935) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2022-01-05 |