| NPI | 1447822820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: LA PLC8665) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: LA PLC8665) |
| Enumeration Date | 2021-07-14 |
| Last Update Date | 2021-07-16 |