| NPI | 1073379418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: MO 2023029748) |
| Additional Taxonomies | 104100000X Social Worker (Licence: KS 13405) |
| Enumeration Date | 2024-02-23 |
| Last Update Date | 2024-02-23 |