NPI | 1841007317 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 347C00000X Private Vehicle |
Additional Taxonomies | 175T00000X Peer Specialist |
251S00000X Community/Behavioral Health | |
Enumeration Date | 2024-12-17 |
Last Update Date | 2024-12-17 |