| NPI | 1902505043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: AK 215403) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NJ 44SL06917900) |
| Enumeration Date | 2023-02-27 |
| Last Update Date | 2024-01-10 |