| NPI | 1184405227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: OR A15262) |
| Additional Taxonomies | 104100000X Social Worker (Licence: GA MSW011446) |
| Enumeration Date | 2023-10-12 |
| Last Update Date | 2024-05-23 |