| NPI | 1174827489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 172V00000X Community Health Worker | |
| 225400000X Rehabilitation Practitioner | |
| Enumeration Date | 2010-12-29 |
| Last Update Date | 2022-02-25 |