| NPI | 1942438940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME118692) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207P00000X Emergency Medicine (Licence: NY 260661) | |
| 207P00000X Emergency Medicine (Licence: OH 122428) | |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2014-07-23 |