NPI | 1013469402 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH TU702342) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OH TU702342) |
Enumeration Date | 2016-11-01 |
Last Update Date | 2016-11-01 |