| NPI | 1568028553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MS M8848) |
| Additional Taxonomies | 104100000X Social Worker (Licence: AL 4055G) |
| Enumeration Date | 2019-05-15 |
| Last Update Date | 2019-05-15 |