NPI | 1588195630 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MA 1015162) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MA 1015162) |
207P00000X Emergency Medicine (Licence: NY 307415) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-03-21 |
Last Update Date | 2023-05-08 |