| NPI | 1689395873 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: UT 1783) |
| Enumeration Date | 2022-09-07 |
| Last Update Date | 2024-12-02 |