NPI | 1235471517 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: VA 0101261653) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2013-03-25 |
Last Update Date | 2017-02-02 |