NPI | 1780207936 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 172V00000X Community Health Worker |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
251S00000X | |
Enumeration Date | 2020-05-22 |
Last Update Date | 2022-05-05 |