| NPI | 1851902415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MD 26215) |
| Additional Taxonomies | 104100000X Social Worker (Licence: PA SW137197) |
| Enumeration Date | 2020-08-16 |
| Last Update Date | 2020-08-16 |