| NPI | 1326981358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MT MED-RES-LIC-173501) |
| Enumeration Date | 2026-04-13 |
| Last Update Date | 2026-06-10 |