| NPI | 1902799232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 146L00000X Emergency Medical Technician, Paramedic |
| Enumeration Date | 2025-06-03 |
| Last Update Date | 2025-06-03 |