| NPI | 1487785697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: LA 7151) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OR 2995) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2025-02-19 |