NPI | 1952787319 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2015-08-07 |
Last Update Date | 2024-11-15 |