| NPI | 1982099057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 294630) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A145314) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-05 |
| Last Update Date | 2022-09-27 |