| NPI | 1386216703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6851114487) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH S.2101858-TRNE) |
| Enumeration Date | 2021-07-14 |
| Last Update Date | 2022-05-26 |