| NPI | 1548731995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: MD 23886) |
| Additional Taxonomies | 104100000X Social Worker (Licence: 23886) |
| Enumeration Date | 2018-12-11 |
| Last Update Date | 2018-12-11 |