| NPI | 1225881006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251B00000X Case Management (Licence: NJ 37LC00232300) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: NJ 37LC00232300) |
| Enumeration Date | 2024-04-10 |
| Last Update Date | 2024-04-10 |