| NPI | 1669162541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 171WH0202X Contractor, Home Modifications |
| 172V00000X Community Health Worker | |
| 247000000X Technician, Health Information | |
| 372500000X Chore Provider | |
| 374700000X Technician | |
| Enumeration Date | 2023-05-12 |
| Last Update Date | 2023-05-12 |