| NPI | 1306515390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MO 2019028364) |
| Additional Taxonomies | 104100000X Social Worker (Licence: KS 11496) |
| Enumeration Date | 2021-09-13 |
| Last Update Date | 2021-09-13 |