| NPI | 1952513863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 036.144408) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MO 2010011927) |
| 207P00000X Emergency Medicine (Licence: IN 01081792A) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO 2032) | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2019-05-10 |