| NPI | 1568343010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: PA SW142767) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MN 34905) |
| Enumeration Date | 2025-09-10 |
| Last Update Date | 2025-09-10 |