| NPI | 1235781600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 171R00000X Interpreter | |
| 171W00000X Contractor | |
| 172A00000X Driver | |
| 175T00000X Peer Specialist | |
| 376K00000X Nurse's Aide | |
| Enumeration Date | 2019-07-15 |
| Last Update Date | 2019-07-15 |