NPI | 1700680543 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 225400000X Rehabilitation Practitioner |
Additional Taxonomies | 101YP1600X Counselor, Pastoral |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2025-04-02 |
Last Update Date | 2025-06-03 |