| NPI | 1144045071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: AZ CHW0000000323) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 251B00000X Case Management | |
| 251S00000X | |
| Enumeration Date | 2024-11-16 |
| Last Update Date | 2024-11-16 |