| NPI | 1871806000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 225C00000X Rehabilitation Counselor |
| Enumeration Date | 2010-07-16 |
| Last Update Date | 2022-03-30 |