| NPI | 1780022111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 104100000X Social Worker |
| 1041S0200X Social Worker, School | |
| Enumeration Date | 2013-06-07 |
| Last Update Date | 2022-11-09 |