| NPI | 1982192456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PT0002X Emergency Medicine, Medical Toxicology (Licence: SC 91878) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101273740) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-30 |
| Last Update Date | 2024-08-02 |