| NPI | 1497126940 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AZ 21792) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: LA 13585) |
| 104100000X Social Worker (Licence: LA 13585) | |
| Enumeration Date | 2015-10-09 |
| Last Update Date | 2023-09-28 |