| NPI | 1457748931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6802087965) |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2023-01-31 |