| NPI | 1982493128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 247200000X Technician, Other (Licence: CA 172V00000xray) |
| Enumeration Date | 2025-05-05 |
| Last Update Date | 2025-06-25 |