NPI | 1306308929 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 306234) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 306234) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-04-02 |
Last Update Date | 2024-02-12 |