| NPI | 1881064947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 101553) |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2015-10-01 |
| Last Update Date | 2024-04-26 |