| NPI | 1508494618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34.017067) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207P00000X Emergency Medicine (Licence: IL 125.076055) | |
| 207P00000X Emergency Medicine (Licence: IL 036.165179) | |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2025-02-19 |