| NPI | 1467893925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CO CSW.09924103) |
| Additional Taxonomies | 104100000X Social Worker (Licence: AZ LMSW-13737) |
| Enumeration Date | 2013-07-12 |
| Last Update Date | 2015-11-12 |