| NPI | 1689378366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: QMHS) |
| Enumeration Date | 2023-03-28 |
| Last Update Date | 2023-09-06 |