| NPI | 1174349930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: KS 14246) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MO 2025028103) |
| Enumeration Date | 2024-11-26 |
| Last Update Date | 2025-11-08 |