| NPI | 1881905503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: UT 8858421-1204) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.010347) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2020-10-06 |