| NPI | 1528415916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner (Licence: CA 225400000X) |
| 101Y00000X Counselor | |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2024-09-06 |