NPI | 1366706152 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME 122748) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN17589) |
Enumeration Date | 2012-06-27 |
Last Update Date | 2015-06-29 |