| NPI | 1720752769 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA 107489) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 105707) |
| Enumeration Date | 2021-08-03 |
| Last Update Date | 2025-06-13 |