| NPI | 1386389302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN M BOEHM Program Director 954-786-6738 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2022-05-03 |
| Last Update Date | 2022-05-03 |