| NPI | 1891143897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A168725) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4351032642) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4351032642) | |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2020-10-30 |