NPI | 1265881445 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 85504) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 201900555) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 217268) | |
Enumeration Date | 2016-06-08 |
Last Update Date | 2020-12-01 |