NPI | 1972983468 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MN 69516) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 5101021629) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 5101021629) | |
Enumeration Date | 2015-06-01 |
Last Update Date | 2023-11-07 |