| NPI | 1841676590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL PSI 29735) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA INT 31104) |
| Enumeration Date | 2015-08-05 |
| Last Update Date | 2015-08-05 |