| NPI | 1427797398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 149315) |
| 171M00000X Case Manager/Care Coordinator | |
| 172V00000X Community Health Worker | |
| Enumeration Date | 2022-05-31 |
| Last Update Date | 2024-09-03 |