| NPI | 1376954693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: OH 35.150233) |
| Additional Taxonomies | 2085R0001X (Licence: IL 036148357) |
| 2085R0001X (Licence: IN 01081948A) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-05-09 |
| Last Update Date | 2024-09-18 |