| NPI | 1821723412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: WI 132745-121) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6851115100) |
| Enumeration Date | 2022-07-19 |
| Last Update Date | 2022-07-19 |