NPI | 1811569031 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX BP10074052) |
Enumeration Date | 2021-07-15 |
Last Update Date | 2021-07-22 |