NPI | 1811502636 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 101Y00000X Counselor |
1744R1102X Specialist, Research Study | |
174H00000X Health Educator | |
175T00000X Peer Specialist | |
251S00000X | |
251V00000X Voluntary or Charitable | |
Enumeration Date | 2020-09-09 |
Last Update Date | 2023-11-27 |