| NPI | 1851882054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: LA 13945) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: LA 13945) |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2024-04-01 |