NPI | 1194492892 |
---|---|
Other Name | JOSH CHAVEZ |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MO 2023029993) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2021-08-30 |
Last Update Date | 2025-04-13 |