| NPI | 1366496051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801016082) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6301002109) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2008-03-28 |