NPI | 1215391511 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 172V00000X Community Health Worker |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
225400000X Rehabilitation Practitioner | |
Enumeration Date | 2016-04-12 |
Last Update Date | 2024-06-21 |