| NPI | 1336754407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6851107757) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6801107757) |
| Enumeration Date | 2020-09-15 |
| Last Update Date | 2021-07-26 |