| NPI | 1376836205 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD H0080009) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.011333) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-05-25 |
| Last Update Date | 2015-08-10 |