| NPI | 1427626241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: CA E145676) |
| Enumeration Date | 2021-06-17 |
| Last Update Date | 2021-06-21 |