NPI | 1083090609 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 172V00000X Community Health Worker (Licence: NV Chw1-6167) |
Additional Taxonomies | 101Y00000X Counselor |
101YP1600X Counselor, Pastoral (Licence: CA 26-0-086-469) | |
Enumeration Date | 2015-08-05 |
Last Update Date | 2025-08-14 |