| NPI | 1891201869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MO 2021009785) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MO 2018004466) |
| 104100000X Social Worker (Licence: KS 10657) | |
| Enumeration Date | 2017-12-28 |
| Last Update Date | 2024-10-09 |