| NPI | 1124755715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AR P2507012) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 91413) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2022-08-03 |
| Last Update Date | 2025-07-22 |