| NPI | 1902485238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME160753) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL ME160753) |
| 207P00000X Emergency Medicine (Licence: IL 036167033) | |
| Enumeration Date | 2021-04-05 |
| Last Update Date | 2024-09-13 |