| NPI | 1336413905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: AR 1478-C) |
| Additional Taxonomies | 104100000X Social Worker (Licence: AR 1478-C) |
| 1041C0700X Social Worker, Clinical (Licence: AR 1478-C) | |
| Enumeration Date | 2012-02-29 |
| Last Update Date | 2012-02-29 |