| NPI | 1679462725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| 101YM0800X Counselor, Mental Health | |
| 372600000X Adult Companion | |
| Enumeration Date | 2025-07-02 |
| Last Update Date | 2025-07-23 |