| NPI | 1962793737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 128138) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 263744) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207P00000X Emergency Medicine (Licence: NY 263744) | |
| 207R00000X Internal Medicine (Licence: CA 128138) | |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2021-12-01 |