| NPI | 1932490661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SC 39162) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D77146) |
| 207P00000X Emergency Medicine (Licence: DC MD043132) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-28 |
| Last Update Date | 2021-06-10 |