| NPI | 1154788081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 104100000X Social Worker (Licence: LA 9946) |
| Enumeration Date | 2016-01-22 |
| Last Update Date | 2018-09-05 |