| NPI | 1407306186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: IN 1276-6403) |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| Enumeration Date | 2016-10-06 |
| Last Update Date | 2016-10-06 |