| NPI | 1831659945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 173000000X Legal Medicine |
| Enumeration Date | 2019-03-24 |
| Last Update Date | 2019-05-22 |