| NPI | 1598529570 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 104100000X Social Worker (Licence: PA SW14006)  | 
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 120121)  | 
| 104100000X Social Worker (Licence: NJ 44SL07095700)  | |
| 104100000X Social Worker (Licence: PA BSW000008)  | |
| 104100000X Social Worker (Licence: RI CSW03661)  | |
| Enumeration Date | 2024-02-09 | 
| Last Update Date | 2025-06-12 |