| NPI | 1790404531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: SC sw.15172) |
| Additional Taxonomies | 104100000X Social Worker (Licence: GA msw010849) |
| Enumeration Date | 2022-08-24 |
| Last Update Date | 2022-08-24 |