NPI | 1932804960 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 171W00000X Contractor |
251S00000X Community/Behavioral Health | |
Enumeration Date | 2023-03-31 |
Last Update Date | 2023-07-23 |