| NPI | 1538773460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 171M00000X Case Manager/Care Coordinator (Licence: WA CM61034508) | |
| Enumeration Date | 2020-09-08 |
| Last Update Date | 2020-11-23 |