| NPI | 1881041002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 171M00000X) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2016-05-17 |
| Last Update Date | 2024-08-13 |