| NPI | 1033990684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: KS 13195) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MO 2023025740) |
| Enumeration Date | 2023-10-10 |
| Last Update Date | 2026-01-29 |