NPI | 1770151300 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 172V00000X Community Health Worker |
Additional Taxonomies | 106S00000X Behavior Technician |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2021-06-10 |
Last Update Date | 2023-10-19 |