| NPI | 1285184598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: HI LSW-2350) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: CO LSW.0009920777) |
| Enumeration Date | 2016-10-11 |
| Last Update Date | 2016-10-11 |