| NPI | 1407362387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101Y00000X Counselor (Licence: LA PLC8841) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2017-12-14 |
| Last Update Date | 2025-01-28 |