| NPI | 1750660981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IA R 9615) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57.019231) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-08-05 |
| Last Update Date | 2013-07-21 |