| NPI | 1114545423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801118969) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6802090922) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2020-07-13 |
| Last Update Date | 2024-09-19 |