| NPI | 1811714256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: PR 15348) |
| Additional Taxonomies | 1041S0200X Social Worker School (Licence: PR 15348) |
| Enumeration Date | 2024-09-25 |
| Last Update Date | 2024-09-25 |