| NPI | 1891321337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 146D00000X Personal Emergency Response Attendant |
| Enumeration Date | 2020-03-17 |
| Last Update Date | 2021-04-30 |