| NPI | 1942469846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 79684) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MD D0072075) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2018-03-17 |