| NPI | 1285449231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174H00000X Health Educator (Licence: NY LA-1863085) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: NY LA-1863085) |
| Enumeration Date | 2025-02-07 |
| Last Update Date | 2025-02-19 |