| NPI | 1487892279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MO 2010016931) |
| Additional Taxonomies | 104100000X Social Worker (Licence: KS 2188) |
| Enumeration Date | 2009-02-02 |
| Last Update Date | 2014-09-29 |