| NPI | 1427341833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 101Y00000X Counselor |
| 104100000X Social Worker (Licence: PR 15885) | |
| Enumeration Date | 2011-05-17 |
| Last Update Date | 2012-07-10 |