NPI | 1720258759 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: MD 0029858 00) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD 11017) |
Enumeration Date | 2008-03-05 |
Last Update Date | 2024-10-07 |