| NPI | 1336906965 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator | 
| Additional Taxonomies | 104100000X Social Worker (Licence: DC 3570304) | 
| Enumeration Date | 2024-02-29 | 
| Last Update Date | 2024-04-03 |