| NPI | 1831982610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2471N0900X Radiologic Technologist, Nuclear Medicine Technology (Licence: MN 044715S-83619) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2025-05-26 |
| Last Update Date | 2025-06-04 |