| NPI | 1174231690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: DC LG200001582) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MD 28250) |
| Enumeration Date | 2022-11-14 |
| Last Update Date | 2022-11-14 |