| NPI | 1174201735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 172V00000X Community Health Worker (Licence: CA 1174201735) | |
| Enumeration Date | 2023-07-05 |
| Last Update Date | 2023-09-01 |