| NPI | 1669841391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 225500000X Specialist/Technologist |
| Enumeration Date | 2015-09-23 |
| Last Update Date | 2015-09-23 |