NPI | 1164778874 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: FL CBHCMS.0100116) |
Additional Taxonomies | 104100000X Social Worker |
Enumeration Date | 2012-07-31 |
Last Update Date | 2023-05-12 |