| NPI | 1740421239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA RC60083835) |
| Enumeration Date | 2009-03-13 |
| Last Update Date | 2010-04-19 |