| NPI | 1952576548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2013-00621) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NE 25163) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2025-01-03 |