NPI | 1831698109 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 172V00000X Community Health Worker |
Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA Y3912691) |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2018-02-01 |
Last Update Date | 2024-08-14 |