| NPI | 1932562527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 293543) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207P00000X Emergency Medicine (Licence: PA MD471102) | |
| 207P00000X Emergency Medicine (Licence: NJ 25MA10861400) | |
| 207P00000X Emergency Medicine (Licence: OH 35.138937) | |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2021-09-17 |