NPI | 1912465402 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT230796) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT230796) |
2083A0100X Preventive Medicine, Aerospace Medicine (Licence: VA 0101270732) | |
208D00000X General Practice (Licence: VA 0101270732) | |
Enumeration Date | 2019-03-04 |
Last Update Date | 2024-06-02 |