| NPI | 1205624558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2024034280) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL HSE38841) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: AZ R80591) | |
| Enumeration Date | 2025-04-28 |
| Last Update Date | 2025-04-28 |