NPI | 1326448127 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34.016690) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 58.030923) | |
Enumeration Date | 2014-08-28 |
Last Update Date | 2023-07-12 |