NPI | 1568029700 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301507358) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 2035741) |
Enumeration Date | 2019-05-23 |
Last Update Date | 2023-04-12 |