| NPI | 1396210746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6851107161) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6851107161) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2018-10-11 |
| Last Update Date | 2022-08-24 |