| NPI | 1396832838 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 077594) |
| Additional Taxonomies | 104100000X Social Worker (Licence: PA SW125184) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2014-01-04 |