| NPI | 1477159150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 174V00000X Clinical Ethicist |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2020-12-08 |
| Last Update Date | 2022-03-16 |