| NPI | 1245364637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: DE Q1-0000872) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: PA CW015436) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2007-07-08 |