| NPI | 1992571095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MO 2022023556) |
| Additional Taxonomies | 104100000X Social Worker (Licence: KS 12521) |
| Enumeration Date | 2023-11-29 |
| Last Update Date | 2023-11-29 |