| NPI | 1205206471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: LA PLC10918) |
| Enumeration Date | 2015-10-01 |
| Last Update Date | 2025-09-23 |