| NPI | 1740151661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NM SWB20261113) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NM SWB20260672) |
| Enumeration Date | 2025-09-15 |
| Last Update Date | 2026-08-13 |