| NPI | 1922869551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 172V00000X Community Health Worker |
| 374J00000X Doula | |
| Enumeration Date | 2024-01-22 |
| Last Update Date | 2026-05-20 |