NPI | 1003343856 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX T7748) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 85221) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: CA D7386274) | |
Enumeration Date | 2017-05-11 |
Last Update Date | 2023-12-22 |