| NPI | 1093429904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: SC 15102) |
| Additional Taxonomies | 104100000X Social Worker (Licence: DC LG50082582) |
| 104100000X Social Worker (Licence: VA 0903003488) | |
| Enumeration Date | 2023-01-06 |
| Last Update Date | 2025-07-31 |