NPI | 1578053948 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN29310) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301114922) |
Enumeration Date | 2018-05-11 |
Last Update Date | 2019-06-20 |