| NPI | 1548983430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 246RP1900X Technician, Pathology, Phlebotomy |
| 2255A2300X Specialist/Technologist, Athletic Trainer | |
| Enumeration Date | 2022-09-26 |
| Last Update Date | 2023-04-10 |