NPI | 1164175402 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AL S13459) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL PSI42545) |
Enumeration Date | 2022-01-27 |
Last Update Date | 2022-01-27 |