| NPI | 1326617317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 27230) |
| 251B00000X Case Management | |
| Enumeration Date | 2021-06-23 |
| Last Update Date | 2021-06-23 |