NPI | 1063856300 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2013-04-17 |
Last Update Date | 2023-04-18 |