| NPI | 1518558006 |
|---|---|
| Other Name | CISCO GONZALES |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 8426) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2021-01-28 |
| Last Update Date | 2023-07-18 |