| NPI | 1871971598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: AZ 007544) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 00000) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-05-14 |
| Last Update Date | 2019-08-21 |