| NPI | 1568875631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174H00000X Health Educator |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 172V00000X Community Health Worker | |
| 246RP1900X Technician, Pathology Phlebotomy | |
| Enumeration Date | 2014-06-06 |
| Last Update Date | 2014-06-06 |