NPI | 1174010516 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 68941) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 75896) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-04-20 |
Last Update Date | 2021-10-29 |