NPI | 1558596403 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT195507) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT195507) |
Enumeration Date | 2009-05-21 |
Last Update Date | 2015-07-06 |