| NPI | 1902680531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 175T00000X Peer Specialist |
| 373H00000X Day Training/Habilitation Specialist | |
| 374J00000X Doula | |
| Enumeration Date | 2023-08-23 |
| Last Update Date | 2023-10-10 |