| NPI | 1518442425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801109013) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6801102210) |
| Enumeration Date | 2018-09-26 |
| Last Update Date | 2021-07-11 |