| NPI | 1932758430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: OH S.2005051) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6851113938) |
| Enumeration Date | 2019-09-06 |
| Last Update Date | 2023-01-10 |