| NPI | 1811491194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CA 194406) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 57.246252) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2024-08-12 |