| NPI | 1972802767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA C171391) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX Q3120) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-03-20 |
| Last Update Date | 2024-01-09 |