| NPI | 1447858014 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174H00000X Health Educator (Licence: LA OMC-LC102) |
| Additional Taxonomies | 174H00000X Health Educator (Licence: LA OMC-LC107) |
| Enumeration Date | 2020-10-15 |
| Last Update Date | 2020-10-16 |