| NPI | 1922450782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 35.136390) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 308379) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-07-05 |
| Last Update Date | 2021-01-20 |