NPI | 1972384402 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 172V00000X Community Health Worker |
101YA0400X Counselor, Addiction (Substance Use Disorder) | |
Enumeration Date | 2023-10-10 |
Last Update Date | 2023-11-08 |