NPI | 1649622762 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 2901022013) |
Enumeration Date | 2016-07-13 |
Last Update Date | 2017-06-12 |