| NPI | 1386438133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174H00000X Health Educator (Licence: AL 3003307719) |
| Additional Taxonomies | 172V00000X Community Health Worker (Licence: AL 3003307719) |
| Enumeration Date | 2025-04-07 |
| Last Update Date | 2025-05-21 |