| NPI | 1174856835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MS C7421) |
| Additional Taxonomies | 104100000X Social Worker (Licence: LA 4494) |
| Enumeration Date | 2009-09-14 |
| Last Update Date | 2009-09-14 |