| NPI | 1073329850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374T00000X Religious Nonmedical Nursing Personnel |
| Additional Taxonomies | 374K00000X Religious Nonmedical Practitioner |
| Enumeration Date | 2024-12-06 |
| Last Update Date | 2024-12-06 |