NPI | 1578309514 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 041467596) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041467596) |
Enumeration Date | 2024-07-08 |
Last Update Date | 2024-07-08 |