| NPI | 1114331295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801097595) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 171M00000X Case Manager/Care Coordinator (Licence: MI 6801097595) | |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2021-05-12 |