| NPI | 1972033017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: KS 10599) |
| Additional Taxonomies | 104100000X Social Worker (Licence: KS 10409) |
| Enumeration Date | 2017-06-12 |
| Last Update Date | 2022-07-21 |