| NPI | 1649600131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: NV CHW-5915) |
| Additional Taxonomies | 225C00000X Rehabilitation Counselor |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2013-11-19 |
| Last Update Date | 2025-04-24 |