| NPI | 1386940831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 104100000X Social Worker (Licence: FL CBHCMS.0100036) |
| 171M00000X Case Manager/Care Coordinator (Licence: FL CBHCMS.0100036) | |
| Enumeration Date | 2011-02-01 |
| Last Update Date | 2025-09-05 |