| NPI | 1184446809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: VA 0903004267) |
| Additional Taxonomies | 104100000X Social Worker (Licence: PA SW141699) |
| Enumeration Date | 2024-10-25 |
| Last Update Date | 2024-10-25 |