| NPI | 1962170498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NV CI5410) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| 172V00000X Community Health Worker | |
| Enumeration Date | 2021-08-31 |
| Last Update Date | 2024-07-29 |