| NPI | 1578980108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: TX 58665) |
| Additional Taxonomies | 104100000X Social Worker (Licence: TX 58665) |
| Enumeration Date | 2014-03-20 |
| Last Update Date | 2014-03-20 |