| NPI | 1932669546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL DO.3208) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 28328) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: AL 3208) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2023-10-13 |