NPI | 1174924294 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 101Y00000X Counselor |
172V00000X Community Health Worker | |
Enumeration Date | 2014-09-08 |
Last Update Date | 2023-08-11 |