| NPI | 1790404044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: GA MSW010710) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 127256) |
| Enumeration Date | 2022-08-22 |
| Last Update Date | 2025-10-14 |