NPI | 1003545351 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225400000X Rehabilitation Practitioner |
Additional Taxonomies | 101YM0800X Counselor Mental Health |
175T00000X Peer Specialist | |
Enumeration Date | 2022-06-09 |
Last Update Date | 2023-10-27 |