| NPI | 1770456592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 374J00000X Doula |
| Additional Taxonomies | 172V00000X Community Health Worker |
| 172A00000X Driver | |
| 175T00000X Peer Specialist | |
| Enumeration Date | 2025-09-26 |
| Last Update Date | 2025-11-17 |