| NPI | 1982015954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL MD.36953) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2017-01652) |
| 208600000X Surgery (Licence: MS 1982015954) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 1982015954) | |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2018-08-02 |