| NPI | 1417302936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246Y00000X Spec/Tech, Health Info |
| Additional Taxonomies | 1744R1102X Specialist, Research Study |
| 174H00000X Health Educator | |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2016-05-03 |