| NPI | 1023400223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: IA 077437) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IL 150.015.162) |
| Enumeration Date | 2015-02-24 |
| Last Update Date | 2017-11-01 |