NPI | 1447686688 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional |
Additional Taxonomies | 172V00000X Community Health Worker |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2013-09-19 |
Last Update Date | 2018-10-22 |