| NPI | 1881086668 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 86496) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GU DO-0086) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-03 |
| Last Update Date | 2020-10-09 |