| NPI | 1386082733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: UT 7872309-3502) |
| Additional Taxonomies | 1041S0200X Social Worker, School (Licence: 567142) |
| Enumeration Date | 2013-06-07 |
| Last Update Date | 2013-06-07 |