NPI | 1912206715 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MS 23756) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207P00000X Emergency Medicine (Licence: LA 205509) | |
Enumeration Date | 2011-03-18 |
Last Update Date | 2015-05-11 |