| NPI | 1952824872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 20A20175) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MB10748200) |
| 207P00000X Emergency Medicine (Licence: NY 308858) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-07-23 |
| Last Update Date | 2023-07-17 |