NPI | 1417498163 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 172V00000X Community Health Worker |
Additional Taxonomies | 104100000X Social Worker |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-03-14 |
Last Update Date | 2017-03-14 |