NPI | 1033636295 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor (Licence: UT 10877207-3502) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2017-08-28 |
Last Update Date | 2020-02-06 |