| NPI | 1225498850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NM M-11361) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NM x-11483) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2016-02-24 |
| Last Update Date | 2020-09-21 |