| NPI | 1295967354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: WA NA000120520) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: WA RC00037875) |
| Enumeration Date | 2009-08-21 |
| Last Update Date | 2009-08-21 |