NPI | 1982065975 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 175T00000X Peer Specialist |
Additional Taxonomies | 101Y00000X Counselor (Licence: WA CG 60135538) |
376K00000X Nurse's Aide (Licence: WA NA 00172315) | |
Enumeration Date | 2016-03-17 |
Last Update Date | 2018-12-13 |