NPI | 1003357864 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TN 4297) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OS020036) |
207P00000X Emergency Medicine (Licence: GA 90259) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-03-13 |
Last Update Date | 2022-09-06 |