NPI | 1730845363 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225400000X Rehabilitation Practitioner |
Additional Taxonomies | 172V00000X Community Health Worker |
101Y00000X Counselor | |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2021-11-09 |
Last Update Date | 2025-08-11 |