| NPI | 1235302928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CA VN233191) |
| 172V00000X Community Health Worker | |
| Enumeration Date | 2008-04-02 |
| Last Update Date | 2024-01-10 |