| NPI | 1841752466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 58.032675) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 250907) |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2022-06-23 |