NPI | 1912037920 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: KY FT401) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 11013533A) |
Enumeration Date | 2007-03-07 |
Last Update Date | 2007-07-08 |