| NPI | 1124378039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: AR 6401-M) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AR 6401-M) |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2019-09-25 |