NPI | 1922631381 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 7769454-3502) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2020-02-13 |
Last Update Date | 2023-07-07 |