| NPI | 1336118694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: WV AP00939763) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH S-0019689) |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2009-03-20 |