| NPI | 1487336566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904012418) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2023-08-07 |
| Last Update Date | 2023-08-07 |