| NPI | 1811515372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: KS 13046) |
| Additional Taxonomies | 104100000X Social Worker (Licence: ID 39806) |
| Enumeration Date | 2020-07-10 |
| Last Update Date | 2023-04-24 |