| NPI | 1891534533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MD 32640) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CT 9366) |
| Enumeration Date | 2024-05-22 |
| Last Update Date | 2025-01-08 |