| NPI | 1013400738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 146L00000X Emergency Medical Technician, Paramedic (Licence: AR 24493) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 171M00000X Case Manager/Care Coordinator | |
| 172V00000X Community Health Worker | |
| 174H00000X Health Educator | |
| 175T00000X Peer Specialist | |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: AR 24493) | |
| 251K00000X Public Health or Welfare | |
| 251V00000X Voluntary or Charitable | |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2021-06-15 |