| NPI | 1992400436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 343330) |
| 207P00000X Emergency Medicine (Licence: CT 84074) | |
| Enumeration Date | 2023-04-03 |
| Last Update Date | 2026-06-30 |