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 |