| NPI | 1881986768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2021-01750) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01072495A) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-05-10 |
| Last Update Date | 2021-09-23 |