| NPI | 1003494931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: MS Pending) |
| Enumeration Date | 2021-03-31 |
| Last Update Date | 2024-04-10 |