NPI | 1376953588 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 296389) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA10252100) |
207P00000X Emergency Medicine (Licence: FL ME146914) | |
207P00000X Emergency Medicine (Licence: TN 72951) | |
207P00000X Emergency Medicine (Licence: CT 70233) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2014-04-28 |
Last Update Date | 2025-09-30 |