NPI | 1326468372 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.130292) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD462787) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2014-04-17 |
Last Update Date | 2017-11-28 |