| NPI | 1467824425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801105455) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6801098365) |
| Enumeration Date | 2015-10-29 |
| Last Update Date | 2019-09-10 |