| NPI | 1487674008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: PA CW013302) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2015-04-10 |