| NPI | 1144567686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174H00000X Health Educator (Licence: NJ MA65020) |
| Additional Taxonomies | 174H00000X Health Educator (Licence: NY 198021-1) |
| Enumeration Date | 2013-01-03 |
| Last Update Date | 2013-01-03 |