| NPI | 1982224341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL OS21122) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 321865) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-04-25 |
| Last Update Date | 2024-08-12 |