NPI | 1518510072 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 172V00000X Community Health Worker |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
225400000X Rehabilitation Practitioner | |
Enumeration Date | 2019-07-23 |
Last Update Date | 2024-07-10 |