| NPI | 1073249785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: DC LG200001762) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MD 28934) |
| Enumeration Date | 2022-07-26 |
| Last Update Date | 2023-07-13 |