| NPI | 1942024138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 104100000X Social Worker |
| 225400000X Rehabilitation Practitioner | |
| Enumeration Date | 2024-11-13 |
| Last Update Date | 2026-07-30 |