| NPI | 1881281848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 3747P1801X Technician Personal Care Attendant |
| 3747P1801X Technician Personal Care Attendant | |
| Enumeration Date | 2020-12-24 |
| Last Update Date | 2020-12-24 |