NPI | 1487150363 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NJ 25MA11637200) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 83835) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-04-01 |
Last Update Date | 2022-11-09 |