| NPI | 1699330928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: NC 2026-02735) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 250517) |
| 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: OH 35.144897) | |
| 208000000X Pediatrics (Licence: OH 35.144897) | |
| Enumeration Date | 2019-05-02 |
| Last Update Date | 2026-07-27 |