| NPI | 1467198051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MA 228545) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: MA 228545) |
| Enumeration Date | 2022-05-07 |
| Last Update Date | 2024-10-01 |