| NPI | 1487342697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 104100000X Social Worker | |
| 172V00000X Community Health Worker | |
| 3747P1801X Technician, Personal Care Attendant | |
| 376J00000X Homemaker | |
| Enumeration Date | 2023-04-26 |
| Last Update Date | 2023-04-26 |