| NPI | 1053932541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: OH S.0024855) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH 524855) |
| Enumeration Date | 2020-05-06 |
| Last Update Date | 2022-05-09 |