NPI | 1356842363 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: KY 59259) |
Additional Taxonomies | 208D00000X General Practice (Licence: NE 32007) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-02-25 |
Last Update Date | 2024-10-31 |