| NPI | 1871098764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A22541) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ R3318) |
| 207P00000X Emergency Medicine (Licence: AZ 010230) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-24 |
| Last Update Date | 2024-09-30 |