| NPI | 1528573730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6801102647) |
| 104100000X Social Worker | |
| Enumeration Date | 2017-12-11 |
| Last Update Date | 2025-07-15 |