NPI | 1174047245 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 56739) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: KY R4756) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT214628) | |
Enumeration Date | 2017-08-01 |
Last Update Date | 2023-03-10 |