NPI | 1558063735 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 172V00000X Community Health Worker |
251S00000X Community/Behavioral Health | |
Enumeration Date | 2023-03-20 |
Last Update Date | 2023-06-07 |