NPI | 1568597151 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: LA 5731) |
Enumeration Date | 2007-02-22 |
Last Update Date | 2018-12-04 |