NPI | 1568874469 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD473058) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 27708) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2014-05-27 |
Last Update Date | 2022-07-21 |