NPI | 1033754338 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: UT 12309986-3501) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2019-11-10 |
Last Update Date | 2024-03-06 |