NPI | 1083901854 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 225400000X Rehabilitation Practitioner |
Enumeration Date | 2011-06-30 |
Last Update Date | 2015-05-27 |