| NPI | 1942006267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 171R00000X Interpreter |
| 251S00000X Community/Behavioral Health | |
| 171400000X Health & Wellness Coach | |
| Enumeration Date | 2025-02-19 |
| Last Update Date | 2025-02-19 |