| NPI | 1255929865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MD 24850) |
| Additional Taxonomies | 1041S0200X Social Worker, School (Licence: MD 24850) |
| Enumeration Date | 2021-01-08 |
| Last Update Date | 2023-10-02 |