| NPI | 1073781449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 136938) |
| Enumeration Date | 2008-02-19 |
| Last Update Date | 2026-03-05 |