NPI | 1194058628 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 101Y00000X Counselor |
172V00000X Community Health Worker | |
Enumeration Date | 2009-09-16 |
Last Update Date | 2023-05-10 |