| NPI | 1447239751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 104100000X Social Worker (Licence: AR 1532C) |
| 1041C0700X Social Worker, Clinical (Licence: AR 1532C) | |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2023-10-02 |