NPI | 1871040261 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 172V00000X Community Health Worker |
Additional Taxonomies | 101YM0800X Counselor Mental Health |
171M00000X Case Manager/Care Coordinator | |
226000000X Recreational Therapist Assistant | |
Enumeration Date | 2016-09-02 |
Last Update Date | 2023-12-20 |