| NPI | 1578952453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 104100000X Social Worker (Licence: NM SWB-2025-1194) |
| Enumeration Date | 2015-01-15 |
| Last Update Date | 2026-02-12 |