| NPI | 1023468915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NM M-09842) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NM X-09758) |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2018-08-29 |