NPI | 1922568849 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD478422) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA mt218971) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-03-25 |
Last Update Date | 2022-06-16 |