NPI | 1699151977 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 251S00000X Community/Behavioral Health |
Additional Taxonomies | 251B00000X Case Management |
251X00000X Supports Brokerage | |
Enumeration Date | 2015-08-10 |
Last Update Date | 2015-08-10 |