| NPI | 1003061045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: 4236690) |
| Additional Taxonomies | 104100000X Social Worker |
| 101Y00000X Counselor | |
| 171M00000X Case Manager/Care Coordinator | |
| 171W00000X Contractor | |
| 172V00000X Community Health Worker | |
| Enumeration Date | 2008-11-18 |
| Last Update Date | 2018-09-05 |