| NPI | 1467004036 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MS M11169) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: MS 2885) |
| Enumeration Date | 2019-07-12 |
| Last Update Date | 2025-08-07 |