| NPI | 1427332899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: FL SW6224) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL SW6224) |
| Enumeration Date | 2011-10-04 |
| Last Update Date | 2011-10-04 |