| NPI | 1922504463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A165652) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MT 113130) |
| 207P00000X Emergency Medicine (Licence: CO CDR.0001736) | |
| 207Q00000X Family Medicine (Licence: MT 113130) | |
| 207Q00000X Family Medicine (Licence: AL MD.42272) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2023-12-01 |