| NPI | 1679068449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: MI 6802033972) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6401003833) |
| 104100000X Social Worker (Licence: MI 6802033972) | |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2018-06-25 |