| NPI | 1427748656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: ID 8921938) |
| Additional Taxonomies | 104100000X Social Worker (Licence: ID 43975) |
| Enumeration Date | 2023-05-10 |
| Last Update Date | 2026-05-19 |