| NPI | 1053138529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: TX SWB-2024-0979) |
| Additional Taxonomies | 104100000X Social Worker (Licence: TX 114297) |
| Enumeration Date | 2024-09-25 |
| Last Update Date | 2024-11-14 |