| NPI | 1528478427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174H00000X Health Educator |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 133NN1002X Nutritionist, Nutrition, Education | |
| Enumeration Date | 2014-04-30 |
| Last Update Date | 2014-04-30 |