| NPI | 1548924533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: OK 8251-P) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MO 2025036763) |
| 1041C0700X Social Worker Clinical (Licence: AR 27919-C) | |
| Enumeration Date | 2021-10-26 |
| Last Update Date | 2025-11-03 |