| NPI | 1619541356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 34.017774) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101027588) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-05-17 |
| Last Update Date | 2025-04-15 |