| NPI | 1023436862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: KS 8991) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MO 2013045395) |
| Enumeration Date | 2014-03-30 |
| Last Update Date | 2014-03-30 |