NPI | 1023482056 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX AT6652) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2015-11-13 |
Last Update Date | 2022-09-01 |