NPI | 1831552876 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: IL 125079151) |
Additional Taxonomies | 208D00000X General Practice (Licence: IN 02005196A) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-03-29 |
Last Update Date | 2021-09-21 |