| NPI | 1619454956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: LA 7441) |
| Additional Taxonomies | 104100000X Social Worker (Licence: LA 7441) |
| Enumeration Date | 2018-07-19 |
| Last Update Date | 2018-08-30 |