NPI | 1962770883 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
225400000X Rehabilitation Practitioner | |
Enumeration Date | 2011-12-06 |
Last Update Date | 2023-12-19 |