| NPI | 1013781889 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: FL 0100469) |
| Additional Taxonomies | 171400000X Health & Wellness Coach (Licence: FL 010469) |
| 174H00000X Health Educator (Licence: FL 0100469) | |
| Enumeration Date | 2023-11-13 |
| Last Update Date | 2023-11-13 |