NPI | 1275029035 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME148062) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN26877) |
Enumeration Date | 2018-07-05 |
Last Update Date | 2021-06-21 |