| NPI | 1508404617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6801109920) |
| 251B00000X Case Management | |
| Enumeration Date | 2019-12-19 |
| Last Update Date | 2021-11-17 |