| NPI | 1861811796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101262822) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 208082) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207P00000X Emergency Medicine (Licence: SC 51270) | |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2023-05-31 |