| NPI | 1417327313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: OH S.1450294) |
| Additional Taxonomies | 104100000X Social Worker (Licence: PA SW132023) |
| Enumeration Date | 2015-10-05 |
| Last Update Date | 2018-06-21 |