| NPI | 1811340714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174H00000X Health Educator |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: CA E056693) |
| 172V00000X Community Health Worker | |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2017-02-08 |