NPI | 1619283371 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
225400000X Rehabilitation Practitioner | |
Enumeration Date | 2010-08-19 |
Last Update Date | 2015-06-03 |