NPI | 1255996161 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0102206502) |
Additional Taxonomies | 208D00000X General Practice (Licence: VA 0102206502) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-05-06 |
Last Update Date | 2023-06-13 |