| NPI | 1811250467 |
|---|---|
| Other Name | JAY ANDREW LONGENBACH |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: PA MT214277) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2020-05-13 |