| NPI | 1003207879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NM M-08336) |
| Additional Taxonomies | 104100000X Social Worker (Licence: TX 57636) |
| Enumeration Date | 2015-02-13 |
| Last Update Date | 2015-02-13 |