| NPI | 1891359212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV DO3201) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX T0412) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2022-07-12 |