| NPI | 1295983393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA CW017438) |
| Additional Taxonomies | 1041S0200X Social Worker, School |
| 104100000X Social Worker (Licence: PA SW126902) | |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2012-09-27 |