| NPI | 1851564413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 104100000X Social Worker (Licence: LA 6152) |
| 251S00000X (Licence: LA 6152) | |
| Enumeration Date | 2008-04-03 |
| Last Update Date | 2021-03-02 |