NPI | 1457914988 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 106S00000X Behavior Technician |
172V00000X Community Health Worker | |
Enumeration Date | 2019-04-19 |
Last Update Date | 2023-07-17 |