| NPI | 1992408801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 06386) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MB13214700) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207P00000X Emergency Medicine (Licence: FL OS23970) | |
| Enumeration Date | 2023-03-22 |
| Last Update Date | 2026-07-24 |