| NPI | 1437416732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 251E00000X Home Health |
| 175T00000X Peer Specialist | |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2026-03-03 |