| NPI | 1932586534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A20209) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ 007953) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-05-03 |
| Last Update Date | 2022-09-21 |