| NPI | 1891299616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME151926) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A166817) |
| 207P00000X Emergency Medicine (Licence: AL MD.45142) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2023-12-15 |