| NPI | 1659983278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: ID LMSW-39886) |
| Additional Taxonomies | 104100000X Social Worker (Licence: TX LMSW-39886) |
| Enumeration Date | 2020-08-17 |
| Last Update Date | 2020-08-17 |