| NPI | 1194343723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 8488) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 171M00000X Case Manager/Care Coordinator | |
| 101YP2500X Counselor, Professional (Licence: PA PC018919) | |
| Enumeration Date | 2020-07-09 |
| Last Update Date | 2026-03-12 |