| NPI | 1558961227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174H00000X Health Educator (Licence: TX 1081) |
| Additional Taxonomies | 246Z00000X Specialist/Technologist, Other (Licence: TX 1081) |
| Enumeration Date | 2020-10-30 |
| Last Update Date | 2020-10-30 |