NPI | 1265918999 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 172V00000X Community Health Worker |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
374700000X Technician | |
Enumeration Date | 2018-07-16 |
Last Update Date | 2023-08-21 |