| NPI | 1619542578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: DE Q3-0010450) |
| Additional Taxonomies | 104100000X Social Worker (Licence: PA SW136352) |
| Enumeration Date | 2021-05-24 |
| Last Update Date | 2021-05-24 |