| NPI | 1881833937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R3305) |
| Additional Taxonomies | 208D00000X General Practice (Licence: HI MD-15406) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: HI MD-15406) | |
| Enumeration Date | 2009-02-12 |
| Last Update Date | 2022-07-21 |