| NPI | 1043322068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX S23276) |
| Additional Taxonomies | 104100000X Social Worker (Licence: TX S23276) |
| 171M00000X Case Manager/Care Coordinator (Licence: TX 23276) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2022-03-07 |