| NPI | 1518487032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: LA 14378) |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2018-09-27 |