| NPI | 1457620684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: OR 1779) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WA 60135320) |
| Enumeration Date | 2011-12-16 |
| Last Update Date | 2011-12-16 |