| NPI | 1710927967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PH0002X Emergency Medicine, Hospice and Palliative Medicine (Licence: OH 34007973-M) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34007973-M) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 34007973-M) | |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2023-06-20 |