| NPI | 1447404397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2004004962) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: MO 2004004962) |
| Enumeration Date | 2008-11-05 |
| Last Update Date | 2021-07-19 |