| NPI | 1942732805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174H00000X Health Educator |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: FL ME 78832) |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2017-03-30 |