NPI | 1962281683 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 172V00000X Community Health Worker |
Additional Taxonomies | 175T00000X Peer Specialist (Licence: CA MPSS-TZOGKW) |
Enumeration Date | 2023-09-22 |
Last Update Date | 2024-04-30 |