| NPI | 1386498285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VT 097.0136344) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2024-04-16 |
| Last Update Date | 2025-11-06 |