| NPI | 1780435974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging |
| 376J00000X Homemaker | |
| Enumeration Date | 2024-03-27 |
| Last Update Date | 2024-05-13 |