| NPI | 1548249360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 104100000X Social Worker (Licence: FL LCSW003390) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2019-11-13 |