| NPI | 1942836812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA A177990) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA student) |
| Enumeration Date | 2020-03-22 |
| Last Update Date | 2023-02-09 |