| NPI | 1669086328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225500000X Specialist/Technologist (Licence: 19983) |
| Additional Taxonomies | 174H00000X Health Educator |
| 246Z00000X Specialist/Technologist, Other (Licence: 19983) | |
| Enumeration Date | 2020-09-01 |
| Last Update Date | 2020-09-01 |