| NPI | 1396131066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA OS023081) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA 20A19532) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: OH 34.013347) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207P00000X Emergency Medicine (Licence: OH 34.013347) | |
| Enumeration Date | 2015-04-09 |
| Last Update Date | 2023-11-10 |