| NPI | 1255842704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MO 2016029104) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IL 150.102528) |
| Enumeration Date | 2017-10-23 |
| Last Update Date | 2017-10-23 |