NPI | 1912611344 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 127059) |
Additional Taxonomies | 172V00000X Community Health Worker |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2023-01-10 |
Last Update Date | 2024-11-21 |