NPI | 1861243677 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 175T00000X Peer Specialist |
Additional Taxonomies | 172V00000X Community Health Worker |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2024-03-29 |
Last Update Date | 2025-05-06 |