| NPI | 1598560328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376K00000X Nurse's Aide (Licence: OH 602927401124) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 172V00000X Community Health Worker | |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2025-02-17 |
| Last Update Date | 2025-04-09 |