| NPI | 1003408501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: WI 10106-25) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WI 4882-226) |
| Enumeration Date | 2021-02-05 |
| Last Update Date | 2024-02-13 |