| NPI | 1699135624 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM A-2380-20) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.013594) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-03 |
| Last Update Date | 2020-07-30 |