| NPI | 1013069335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: WA LW00006366) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA LH00004258) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2009-03-31 |