NPI | 1750001707 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA 12288) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2022-08-30 |
Last Update Date | 2022-09-12 |