| NPI | 1669790226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: TX 27132) |
| Enumeration Date | 2010-05-06 |
| Last Update Date | 2020-05-26 |