NPI | 1609185263 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IA MD-44379) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN PERMIT22870) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: MN PERMIT22870) | |
Enumeration Date | 2010-09-30 |
Last Update Date | 2021-01-08 |