| NPI | 1811387376 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174H00000X Health Educator (Licence: 17h0000x) |
| Additional Taxonomies | 174H00000X Health Educator (Licence: MA level II) |
| Enumeration Date | 2015-02-04 |
| Last Update Date | 2015-02-04 |