| NPI | 1700306735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NM SWB-2023-0374) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2024-01-08 |