| NPI | 1467561308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA RC00040545) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-12-02 |