NPI | 1265701759 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WY LCSW-1666) |
Enumeration Date | 2011-12-29 |
Last Update Date | 2024-04-27 |