NPI | 1073122511 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 376G00000X Nursing Home Administrator |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
Enumeration Date | 2020-07-30 |
Last Update Date | 2020-08-13 |