NPI | 1336702950 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 101YP2500X Counselor, Professional |
103TC1900X Psychologist, Counseling | |
Enumeration Date | 2019-04-18 |
Last Update Date | 2019-08-20 |