| NPI | 1073236634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: TN LSW0000013017) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CO SWC.0000000991) |
| 104100000X Social Worker (Licence: TN 0000013017) | |
| Enumeration Date | 2022-09-20 |
| Last Update Date | 2022-09-20 |