| NPI | 1457501272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: FL SW15278) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2008-09-29 |
| Last Update Date | 2024-10-14 |