| NPI | 1487930616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 73000019A) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: KY FT484) |
| Enumeration Date | 2011-11-02 |
| Last Update Date | 2011-11-02 |