| NPI | 1902212657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME163312) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 26233) |
| 207P00000X Emergency Medicine (Licence: TN 55766) | |
| 208M00000X Hospitalist (Licence: KY 49912) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MN 26233) | |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2023-09-13 |