| NPI | 1144935495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 104100000X Social Worker (Licence: LA 17597) |
| Enumeration Date | 2023-01-20 |
| Last Update Date | 2023-02-01 |