NPI | 1790444602 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: CA 281328) |
172V00000X Community Health Worker | |
Enumeration Date | 2021-12-08 |
Last Update Date | 2024-03-18 |