| NPI | 1770960437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 104100000X Social Worker |
| 372600000X Adult Companion | |
| Enumeration Date | 2015-05-01 |
| Last Update Date | 2019-11-15 |