| NPI | 1568833424 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174H00000X Health Educator (Licence: NY 690658121) |
| Additional Taxonomies | 174H00000X Health Educator (Licence: NY 690659121) |
| Enumeration Date | 2015-10-16 |
| Last Update Date | 2015-10-16 |