| NPI | 1366298432 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC RTL24-0124) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC ABDE-A9EXPP) |
| Enumeration Date | 2024-04-29 |
| Last Update Date | 2024-08-01 |