| NPI | 1932962651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA APCC16267) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2024-02-05 |
| Last Update Date | 2024-04-25 |