| NPI | 1386383479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: TX 13530) |
| Additional Taxonomies | 175F00000X Naturopath |
| 174H00000X Health Educator (Licence: TX 13530) | |
| 175T00000X Peer Specialist | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-05-27 |
| Last Update Date | 2023-11-04 |