NPI | 1821394842 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 7969592-3502) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2011-02-09 |
Last Update Date | 2022-07-21 |