NPI | 1609526136 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 335845) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 82077) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2022-03-27 |
Last Update Date | 2025-07-24 |