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 |