NPI | 1679283634 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 175T00000X Peer Specialist (Licence: NV PRSS-5030) |
Additional Taxonomies | 172V00000X Community Health Worker (Licence: NV CHW2-5022) |
Enumeration Date | 2022-11-30 |
Last Update Date | 2022-11-30 |