| NPI | 1730933268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 171400000X Health & Wellness Coach | |
| 171M00000X Case Manager/Care Coordinator | |
| 174H00000X Health Educator | |
| 251K00000X Public Health or Welfare | |
| 374K00000X | |
| Enumeration Date | 2024-04-12 |
| Last Update Date | 2024-04-12 |