| NPI | 1255960795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN CV2000037) |
| Additional Taxonomies | 261QR1100X Clinic/Center Research |
| 261QR1100X Clinic/Center Research (Licence: IN XXXXXXX3X) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NJ XXXXXXXXX) | |
| 101YP2500X Counselor Professional (Licence: NJ XXXXXXXXX) | |
| 101YP2500X Counselor Professional (Licence: IN XXXXXXX3X) | |
| 101YP2500X Counselor Professional (Licence: NJ NJDCATEMP-032353) | |
| 101YP2500X Counselor Professional | |
| 261QP2300X Clinic/Center Primary Care (Licence: NJ NJDCATEMP-032353) | |
| 261QP2300X Clinic/Center Primary Care (Licence: IN CV2000037) | |
| 261QP2300X Clinic/Center Primary Care | |
| 261QP2300X Clinic/Center Primary Care (Licence: IN XXXXXXX3X) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN XXXXXXX3X) | |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2022-07-17 |