NPI | 1689037178 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MS 27562) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AR 917240188) |
207P00000X Emergency Medicine (Licence: LA 307123) | |
Enumeration Date | 2016-04-01 |
Last Update Date | 2020-06-29 |