| NPI | 1023706041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246Z00000X Specialist/Technologist, Other (Licence: CO 24531) |
| Additional Taxonomies | 171400000X Health & Wellness Coach |
| 247200000X Technician, Other | |
| 374K00000X | |
| 374U00000X Home Health Aide (Licence: CO NA.00764940) | |
| 376K00000X Nurse's Aide (Licence: CO NA.00764940) | |
| Enumeration Date | 2023-04-27 |
| Last Update Date | 2023-08-18 |