| NPI | 1679258560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MD 30077) |
| Additional Taxonomies | 104100000X Social Worker (Licence: DC LG200002611) |
| Enumeration Date | 2023-06-19 |
| Last Update Date | 2023-06-19 |