| NPI | 1215448808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: LA 7074) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: LA 7074) |
| Enumeration Date | 2017-10-23 |
| Last Update Date | 2023-04-14 |