| NPI | 1528915857 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174H00000X Health Educator |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 174400000X Specialist | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2026-03-16 |
| Last Update Date | 2026-03-16 |