NPI | 1669717104 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 8345472-3501) |
Additional Taxonomies | 104100000X Social Worker (Licence: UT 8345472-3502) |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2012-12-11 |
Last Update Date | 2018-04-18 |