| NPI | 1902556228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A202021) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV 26203) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NV 390200000X) | |
| Enumeration Date | 2022-03-28 |
| Last Update Date | 2025-06-11 |