NPI | 1831893122 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
172V00000X Community Health Worker | |
Enumeration Date | 2023-03-29 |
Last Update Date | 2024-04-03 |