| NPI | 1366072308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174H00000X Health Educator |
| Additional Taxonomies | 1744G0900X Specialist, Graphics Designer |
| 226000000X Recreational Therapist Assistant | |
| Enumeration Date | 2020-01-17 |
| Last Update Date | 2020-09-04 |