| NPI | 1639873318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 251S00000X |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2023-03-28 |
| Last Update Date | 2023-07-20 |