| NPI | 1891294310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: OH I.2304998) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH 1600496) |
| Enumeration Date | 2018-02-10 |
| Last Update Date | 2023-11-28 |