| NPI | 1033363296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: NM I-07010) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NM I-07010) |
| Enumeration Date | 2008-11-13 |
| Last Update Date | 2014-06-09 |