NPI | 1437860186 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1710I1002X Military Health Care Provider, Independent Duty Corpsman |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2022-12-13 |
Last Update Date | 2023-06-05 |