NPI | 1508150913 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NV 15267) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207P00000X Emergency Medicine (Licence: KY 47152) | |
Enumeration Date | 2011-06-02 |
Last Update Date | 2015-03-08 |