| NPI | 1073933057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34.011965) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NV DO2174) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: OH 34.011965) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-17 |
| Last Update Date | 2024-07-26 |