| NPI | 1790132199 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MD469018) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.134694) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2023-01-09 |