| NPI | 1114167038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 104100000X Social Worker (Licence: TX 26221) |
| Enumeration Date | 2009-03-05 |
| Last Update Date | 2015-08-19 |