| NPI | 1437645264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 174H00000X Health Educator |
| 101YM0800X Counselor, Mental Health | |
| 251B00000X Case Management | |
| Enumeration Date | 2018-07-04 |
| Last Update Date | 2018-07-04 |