NPI | 1063876472 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 96831) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2020-03208) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-04-12 |
Last Update Date | 2024-03-29 |