| NPI | 1770781379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2470A2800X Technician, Health Information, Assistant Record Technician |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 104100000X Social Worker | |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2022-05-16 |