| NPI | 1285686998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KS 053) |
| Additional Taxonomies | 104100000X Social Worker (Licence: KS 5836) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2016-05-24 |