| NPI | 1568131951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: FL CBHCMS101089) |
| Enumeration Date | 2021-09-08 |
| Last Update Date | 2023-04-20 |