| NPI | 1457730210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: MI 6802061483) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6802061483) |
| Enumeration Date | 2015-05-27 |
| Last Update Date | 2024-08-08 |