NPI | 1932551603 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MD D0086556) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116029831) |
Enumeration Date | 2016-07-06 |
Last Update Date | 2019-04-27 |