| NPI | 1760348098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 14677) |
| Enumeration Date | 2025-12-30 |
| Last Update Date | 2026-02-03 |