| NPI | 1831704659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MO 2020026573) |
| Additional Taxonomies | 104100000X Social Worker (Licence: KS 11682) |
| Enumeration Date | 2020-09-09 |
| Last Update Date | 2020-09-09 |