| NPI | 1225864317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| 373H00000X Day Training/Habilitation Specialist | |
| Enumeration Date | 2024-09-13 |
| Last Update Date | 2024-09-25 |