| NPI | 1699507798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: KS 13628) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MO 2024023437) |
| Enumeration Date | 2024-08-16 |
| Last Update Date | 2024-09-19 |