NPI | 1689317570 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA 2610) |
Additional Taxonomies | 2255A2300X Specialist/Technologist Athletic Trainer |
Enumeration Date | 2022-04-18 |
Last Update Date | 2022-10-13 |