| NPI | 1073135000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: TX 106866) |
| Additional Taxonomies | 104100000X Social Worker (Licence: PA SW142208) |
| Enumeration Date | 2020-05-13 |
| Last Update Date | 2025-02-07 |