| NPI | 1245591411 | 
|---|---|
| Former Name | SKYYDO C MBAZANG | 
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 374U00000X Home Health Aide | 
| Additional Taxonomies | 172V00000X Community Health Worker | 
| Enumeration Date | 2012-06-05 | 
| Last Update Date | 2023-07-20 |