| NPI | 1700370517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MD 23441) |
| Additional Taxonomies | 104100000X Social Worker (Licence: DC LG50082373) |
| Enumeration Date | 2018-06-15 |
| Last Update Date | 2018-06-15 |