NPI | 1306365424 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 175T00000X Peer Specialist (Licence: OH 00284) |
Additional Taxonomies | 175T00000X Peer Specialist (Licence: 00284) |
Enumeration Date | 2017-09-11 |
Last Update Date | 2017-09-11 |