| NPI | 1427081371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: WI 3435) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 3435-125) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2020-09-16 |