| NPI | 1891010740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 288541) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207P00000X Emergency Medicine (Licence: WA MD60493804) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: NY 288541) | |
| Enumeration Date | 2010-04-05 |
| Last Update Date | 2019-06-21 |