| NPI | 1033882261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 34.017971) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.017971) |
| 207P00000X Emergency Medicine (Licence: NY 332470) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-07-25 |
| Last Update Date | 2025-06-16 |