| NPI | 1770998809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801106827) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6801096913) |
| Enumeration Date | 2014-06-27 |
| Last Update Date | 2023-03-10 |