| NPI | 1841788551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: NY 320048) |
| Enumeration Date | 2018-04-27 |
| Last Update Date | 2024-06-20 |