| NPI | 1407214984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 104100000X Social Worker (Licence: LA 13587) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2016-01-29 |
| Last Update Date | 2024-12-12 |