| NPI | 1144773508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041S0200X Social Worker School (Licence: UT 12201049-6009) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2016-08-02 |
| Last Update Date | 2022-08-18 |