| NPI | 1275952319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NM M-10305) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NM X-10386) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2018-08-27 |