| NPI | 1427770072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: TX 103597) |
| Additional Taxonomies | 104100000X Social Worker (Licence: LA 7524) |
| Enumeration Date | 2022-09-12 |
| Last Update Date | 2022-09-12 |