| NPI | 1386850089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: PA SW-007353-L) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: DE Q1-0000369) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2007-07-08 |