| NPI | 1316525769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NC C015716) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MD 24668) |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2023-06-14 |