| NPI | 1124788831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: DE Q3-0010861) |
| Additional Taxonomies | 104100000X Social Worker (Licence: TX 106610) |
| Enumeration Date | 2021-12-21 |
| Last Update Date | 2021-12-21 |