NPI | 1659502177 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OH 58.003559) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34.010462) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: NV SL0654) | |
Enumeration Date | 2009-07-31 |
Last Update Date | 2016-12-30 |