| NPI | 1730878232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC RTL23-0132) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC ANDE-SDO4FL) |
| Enumeration Date | 2023-05-02 |
| Last Update Date | 2023-05-03 |