| NPI | 1720671399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: MD 25551) |
| Additional Taxonomies | 104100000X Social Worker (Licence: DC LG50082342) |
| Enumeration Date | 2021-02-15 |
| Last Update Date | 2021-02-15 |