| NPI | 1285169060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: MD 20928) |
| Additional Taxonomies | 104100000X Social Worker (Licence: DC LG101506) |
| Enumeration Date | 2017-04-28 |
| Last Update Date | 2017-04-28 |