NPI | 1578367934 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 172V00000X Community Health Worker |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 1528435419) |
Enumeration Date | 2025-04-03 |
Last Update Date | 2025-04-03 |