| NPI | 1184464331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 171400000X Health & Wellness Coach |
| 174H00000X Health Educator | |
| 172V00000X Community Health Worker | |
| 372600000X Adult Companion | |
| 175T00000X Peer Specialist | |
| 101YP1600X Counselor, Pastoral | |
| Enumeration Date | 2024-05-27 |
| Last Update Date | 2025-10-06 |