| NPI | 1467821587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101Y00000X Counselor |
| 101Y00000X Counselor (Licence: IL 362170821) | |
| Enumeration Date | 2015-09-18 |
| Last Update Date | 2018-05-11 |