| NPI | 1396023958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6802086254) |
| Enumeration Date | 2011-08-01 |
| Last Update Date | 2016-10-24 |