NPI | 1528794153 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor |
Additional Taxonomies | 172V00000X Community Health Worker |
225400000X Rehabilitation Practitioner | |
Enumeration Date | 2022-07-26 |
Last Update Date | 2023-05-19 |