NPI | 1447703061 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 8975) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2016-08-01 |
Last Update Date | 2025-02-08 |