| NPI | 1700301553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MT DEN-DEN-LIC-13512) |
| Enumeration Date | 2017-08-12 |
| Last Update Date | 2023-07-19 |