| NPI | 1194508754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: NC P020375) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MD 30563) |
| Enumeration Date | 2023-08-17 |
| Last Update Date | 2024-05-31 |