| NPI | 1457870404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: TX 30407) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: TX 30407) |
| Enumeration Date | 2017-09-11 |
| Last Update Date | 2017-09-11 |