| NPI | 1750765319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: PA CW020259) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NJ 44SL06162900) |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2018-12-12 |