| NPI | 1376086751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: LA 16086) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2016-12-02 |
| Last Update Date | 2023-01-23 |