NPI | 1659412294 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 167G00000X Licensed Psychiatric Technician (Licence: CA 28188) |
Enumeration Date | 2007-02-08 |
Last Update Date | 2018-06-28 |