| NPI | 1336883289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: ID 34093) |
| Additional Taxonomies | 104100000X Social Worker (Licence: ID LMSW-34093) |
| Enumeration Date | 2022-04-26 |
| Last Update Date | 2022-04-26 |