| NPI | 1427899681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57.257035) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 57.257035) |
| Enumeration Date | 2024-06-03 |
| Last Update Date | 2024-06-03 |