NPI | 1619741238 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 794818) |
Additional Taxonomies | 101YS0200X Counselor, School (Licence: NY 794818) |
174400000X Specialist (Licence: NY 794818) | |
174H00000X Health Educator (Licence: NY 794818) | |
Enumeration Date | 2023-11-14 |
Last Update Date | 2024-08-30 |