| NPI | 1730866419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: ID LMSW-43549) |
| Additional Taxonomies | 104100000X Social Worker (Licence: UT 13409600-3502) |
| Enumeration Date | 2023-07-03 |
| Last Update Date | 2023-07-03 |