| NPI | 1295069086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP20041357) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OR LL18887) |
| Enumeration Date | 2009-09-25 |
| Last Update Date | 2011-06-29 |