NPI | 1184080046 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA PLC8270) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
261QM0801X | |
Enumeration Date | 2016-01-07 |
Last Update Date | 2023-06-15 |