| NPI | 1285331207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: AL 6067G) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MD 29501) |
| Enumeration Date | 2023-02-09 |
| Last Update Date | 2023-08-04 |