NPI | 1386383479 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 174H00000X Health Educator (Licence: TX 13530) |
Additional Taxonomies | 251B00000X Case Management |
171400000X Health & Wellness Coach | |
172V00000X Community Health Worker (Licence: TX 13530) | |
175T00000X Peer Specialist | |
Enumeration Date | 2022-05-27 |
Last Update Date | 2025-09-17 |