| NPI | 1225403801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174H00000X Health Educator (Licence: CT 02281) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: CT 022381) |
| Enumeration Date | 2015-12-08 |
| Last Update Date | 2015-12-08 |