NPI | 1295090645 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA ASW32717) |
Enumeration Date | 2012-07-11 |
Last Update Date | 2018-05-17 |