| NPI | 1649368374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: ND 079046) |
| Additional Taxonomies | 104100000X Social Worker (Licence: ND 2115) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2025-09-11 |