| NPI | 1154766814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 4667) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.014590) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-05-07 |
| Last Update Date | 2022-03-22 |