| NPI | 1306078373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: GA MSW002654) |
| Additional Taxonomies | 1041S0200X Social Worker School (Licence: GA S5- CERTIFICATION) |
| Enumeration Date | 2009-08-10 |
| Last Update Date | 2009-08-10 |