| NPI | 1942521026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: LA 310163) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA MD60378320) |
| 207P00000X Emergency Medicine (Licence: NH 17956) | |
| 208D00000X General Practice (Licence: IN 01070713A) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-06-12 |
| Last Update Date | 2018-09-19 |