| NPI | 1366596421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: AZ 1553) |
| Additional Taxonomies | 373H00000X Day Training/Habilitation Specialist (Licence: AZ 1553) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2010-12-01 |