| NPI | 1760255871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MO 2023043290) |
| Additional Taxonomies | 104100000X Social Worker (Licence: KS 13385) |
| Enumeration Date | 2023-10-31 |
| Last Update Date | 2023-10-31 |