| NPI | 1699548925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic |
| 174H00000X Health Educator | |
| Enumeration Date | 2023-10-30 |
| Last Update Date | 2023-10-31 |