| NPI | 1871232181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: IA 121277) |
| Additional Taxonomies | 104100000X Social Worker (Licence: LA 16548) |
| 104100000X Social Worker (Licence: CA 115094) | |
| Enumeration Date | 2022-06-03 |
| Last Update Date | 2023-07-06 |