| NPI | 1700920451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 225C00000X Rehabilitation Counselor | |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2007-07-08 |