| NPI | 1316649247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: PA SW104344) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IL 150110819) |
| 104100000X Social Worker (Licence: MD 30303) | |
| Enumeration Date | 2023-03-22 |
| Last Update Date | 2023-07-23 |