| NPI | 1689395501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: MA 228454) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CT 6506) |
| Enumeration Date | 2022-09-08 |
| Last Update Date | 2022-09-08 |