| NPI | 1770842379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 374U00000X Home Health Aide (Licence: DC 2966135) |
| 171M00000X Case Manager/Care Coordinator | |
| 1041S0200X Social Worker, School | |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2026-03-08 |