NPI | 1578774402 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: FL ME101690) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207P00000X Emergency Medicine (Licence: LA MD.201559) | |
Enumeration Date | 2007-05-24 |
Last Update Date | 2011-06-07 |