| NPI | 1922367531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R3444) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4301100413) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2017-11-17 |