| NPI | 1417307018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: AR P2009072) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2020-09-13 |