| NPI | 1285286385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 104100000X Social Worker (Licence: LA 15045) |
| Enumeration Date | 2019-07-10 |
| Last Update Date | 2019-07-10 |