NPI | 1124524624 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WA OP61181173) |
Additional Taxonomies | 208D00000X General Practice (Licence: VA 0102205801) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-04-03 |
Last Update Date | 2021-11-09 |