| NPI | 1306899083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: MD 12488) |
| Additional Taxonomies | 104100000X Social Worker (Licence: DC LG1000397) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2007-11-06 |