| NPI | 1881128429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: TN 106871779) |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2017-04-27 |