| NPI | 1982184792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OK 21109) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 104100000X Social Worker | |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2024-08-30 |