| NPI | 1699565168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: NV CHW1-6144) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2025-05-08 |
| Last Update Date | 2025-06-20 |