| NPI | 1952164659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker (Licence: PA 20242) |
| Additional Taxonomies | 174N00000X Lactation Consultant, Non-RN (Licence: NY 20190410) |
| 374J00000X Doula (Licence: OR LW01) | |
| Enumeration Date | 2024-02-05 |
| Last Update Date | 2024-05-15 |