NPI | 1962054148 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: OH I.2304550) |
Additional Taxonomies | 104100000X Social Worker (Licence: KY 259375) |
Enumeration Date | 2019-07-09 |
Last Update Date | 2024-08-02 |