| NPI | 1336439678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.122064) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01075210A) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2017-06-16 |