| NPI | 1588258396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: GA DN123613) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AL D.007243-C1) |
| Enumeration Date | 2021-02-22 |
| Last Update Date | 2024-10-21 |