| NPI | 1902529597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CPOO451583) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WV CPOO451583) |
| Enumeration Date | 2022-09-20 |
| Last Update Date | 2022-09-20 |