| NPI | 1942725916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 315605) |
| Additional Taxonomies | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: PA MT212560) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-08-10 |
| Last Update Date | 2022-06-14 |