NPI | 1053052589 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX 327000) |
Enumeration Date | 2022-04-06 |
Last Update Date | 2024-03-15 |