| NPI | 1922632173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MS 32420) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.143907) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 35.143907) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-02-26 |
| Last Update Date | 2023-11-03 |