| NPI | 1295126472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: OH S.2614212) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CA 107241) |
| Enumeration Date | 2015-02-10 |
| Last Update Date | 2026-08-25 |