| NPI | 1053051359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 374J00000X Doula |
| 374K00000X Religious Nonmedical Practitioner | |
| Enumeration Date | 2022-04-01 |
| Last Update Date | 2022-04-01 |