| NPI | 1740087410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: SC 15123) |
| Additional Taxonomies | 104100000X Social Worker (Licence: HI LSW-3195) |
| Enumeration Date | 2025-02-28 |
| Last Update Date | 2025-04-15 |