| NPI | 1215393129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 104100000X Social Worker (Licence: LA 8337) | |
| Enumeration Date | 2016-01-07 |
| Last Update Date | 2023-06-28 |