NPI | 1255658555 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P3687) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35135722) |
207PE0004X Emergency Medicine Emergency Medical Services (Licence: OH 35135722) | |
2086S0102X Surgery Surgical Critical Care (Licence: TX P3687) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2010-04-26 |
Last Update Date | 2021-07-28 |