| NPI | 1932780350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 330301) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 3330301) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-04-16 |
| Last Update Date | 2024-06-06 |