| NPI | 1467166231 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 104100000X Social Worker | 
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator | 
| 253Z00000X In Home Supportive Care | |
| Enumeration Date | 2023-01-06 | 
| Last Update Date | 2023-06-27 |