| NPI | 1972645489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251B00000X Case Management (Licence: TX 26309) |
| Additional Taxonomies | 104100000X Social Worker (Licence: TX 26309) |
| 171M00000X Case Manager/Care Coordinator (Licence: TX 26309) | |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2008-08-19 |