NPI | 1740745959 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 251S00000X (Licence: PA BH004113) |
Enumeration Date | 2019-02-01 |
Last Update Date | 2023-05-16 |