| NPI | 1164897153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801109330) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6801097390) |
| Enumeration Date | 2015-12-02 |
| Last Update Date | 2023-03-07 |