| NPI | 1003341496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: OH 35.145725) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 227190) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-24 |
| Last Update Date | 2023-11-03 |