NPI | 1063907970 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 251S00000X Community/Behavioral Health |
Additional Taxonomies | 172V00000X Community Health Worker |
251K00000X Public Health or Welfare | |
Enumeration Date | 2018-06-25 |
Last Update Date | 2018-07-16 |