| NPI | 1225749773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: TX 108703) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WA SA61356300) |
| Enumeration Date | 2022-12-06 |
| Last Update Date | 2022-12-06 |