| NPI | 1669996096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: LA 213469) |
| Additional Taxonomies | 104100000X Social Worker |
| 171M00000X Case Manager/Care Coordinator (Licence: LA 14369) | |
| Enumeration Date | 2017-07-27 |
| Last Update Date | 2024-07-15 |