| NPI | 1851830863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NV 11680-C) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 093367-1) |
| Enumeration Date | 2017-02-23 |
| Last Update Date | 2026-02-06 |