| NPI | 1942706866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 56886) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: TX 56886) |
| Enumeration Date | 2018-03-30 |
| Last Update Date | 2025-08-07 |