| NPI | 1922888791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| 3747A0650X Technician, Attendant Care Provider | |
| 3747P1801X Technician, Personal Care Attendant | |
| Enumeration Date | 2023-09-29 |
| Last Update Date | 2023-10-02 |