| NPI | 1962949255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: OH I.2406081) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH s.2107095) |
| Enumeration Date | 2017-01-24 |
| Last Update Date | 2025-01-24 |