| NPI | 1821632522 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: OH I.2002498) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH S.1303293) |
| Enumeration Date | 2019-11-05 |
| Last Update Date | 2021-08-12 |