| NPI | 1013747070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: TX 112489) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OK 20971) |
| 104100000X Social Worker (Licence: MD 31372) | |
| Enumeration Date | 2024-08-05 |
| Last Update Date | 2024-08-05 |