NPI | 1982102711 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 225400000X Rehabilitation Practitioner |
Enumeration Date | 2018-01-26 |
Last Update Date | 2024-09-04 |