NPI | 1568289080 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 175T00000X Peer Specialist (Licence: OK W083649015) |
Additional Taxonomies | 175T00000X Peer Specialist (Licence: OK 083649015) |
Enumeration Date | 2024-09-25 |
Last Update Date | 2024-09-25 |