| NPI | 1548499825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: WA ML 60161072) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA 240636) |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2012-10-15 |