| NPI | 1992423545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX BP10070146) |
| 101200000X Drama Therapist | |
| Enumeration Date | 2022-08-19 |
| Last Update Date | 2023-01-30 |