NPI | 1427711506 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
101YA0400X Counselor, Addiction (Substance Use Disorder) | |
Enumeration Date | 2021-10-15 |
Last Update Date | 2023-03-08 |