| NPI | 1396577862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174H00000X Health Educator |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 172V00000X Community Health Worker | |
| 174V00000X Clinical Ethicist | |
| 251V00000X Voluntary or Charitable | |
| Enumeration Date | 2024-08-14 |
| Last Update Date | 2024-08-14 |