| NPI | 1881488450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 104100000X Social Worker |
| 374700000X Technician | |
| Enumeration Date | 2025-04-08 |
| Last Update Date | 2025-06-03 |