| NPI | 1831880251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MO 2023022350) |
| Additional Taxonomies | 104100000X Social Worker (Licence: TX 110324) |
| 104100000X Social Worker (Licence: UT 13382587-3502) | |
| Enumeration Date | 2023-05-17 |
| Last Update Date | 2023-06-15 |