| NPI | 1225363740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: MD 14345) |
| Additional Taxonomies | 104100000X Social Worker (Licence: DC LG50078838) |
| Enumeration Date | 2009-10-16 |
| Last Update Date | 2009-10-16 |