| NPI | 1043892664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 225400000X) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2021-04-22 |
| Last Update Date | 2025-05-12 |