| NPI | 1205376829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: SC 11807) |
| Additional Taxonomies | 104100000X Social Worker (Licence: GA MSW007519) |
| Enumeration Date | 2017-03-01 |
| Last Update Date | 2017-03-01 |