NPI | 1285096222 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: VT 042.0018922) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VT 042.0018922) |
2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: CO DR.0068903) | |
2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: NM MD2019-0980) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-03-28 |
Last Update Date | 2025-09-26 |