| NPI | 1437218237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: KS LMSW 5064) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 13-134154-082) |
| Enumeration Date | 2006-12-07 |
| Last Update Date | 2022-07-21 |