| NPI | 1912529900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 202203195) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207P00000X Emergency Medicine (Licence: WA OP61398807) | |
| Enumeration Date | 2020-05-12 |
| Last Update Date | 2023-09-14 |