| NPI | 1043044803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: NV CHW1-5834) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: NV CHW2-5156) |
| Enumeration Date | 2024-08-26 |
| Last Update Date | 2026-09-02 |