NPI | 1124505466 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 225400000X Rehabilitation Practitioner |
Enumeration Date | 2018-07-19 |
Last Update Date | 2024-08-28 |