NPI | 1063277085 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 172V00000X Community Health Worker |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2024-02-19 |
Last Update Date | 2024-08-04 |