| NPI | 1942735360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX T9775) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OK 33974) |
| 207P00000X Emergency Medicine (Licence: IN 01085996A) | |
| 207P00000X Emergency Medicine (Licence: LA 334003) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-23 |
| Last Update Date | 2023-02-01 |