| NPI | 1477153955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 246Y00000X Spec/Tech, Health Info |
| 246QL0900X Spec/Tech, Pathology, Laboratory Management | |
| 2472E0500X Technician, Other, EEG | |
| 101YM0800X Counselor, Mental Health | |
| 132700000X Dietary Manager | |
| 225C00000X Rehabilitation Counselor | |
| Enumeration Date | 2020-10-26 |
| Last Update Date | 2022-06-21 |