NPI | 1801085907 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 172V00000X Community Health Worker |
Additional Taxonomies | 101Y00000X Counselor |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2007-10-15 |
Last Update Date | 2023-05-08 |