| NPI | 1578201877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801120107) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6851114500) |
| Enumeration Date | 2022-05-25 |
| Last Update Date | 2025-04-16 |