| NPI | 1245955285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: TX 108921) |
| Additional Taxonomies | 104100000X Social Worker (Licence: KS 13577) |
| Enumeration Date | 2022-10-11 |
| Last Update Date | 2024-11-19 |