| NPI | 1720680671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AR 9040) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AR P2302021) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2020-11-14 |
| Last Update Date | 2023-03-02 |