| NPI | 1548448251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: FL SW10465) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: DC LC303213) |
| Enumeration Date | 2008-02-05 |
| Last Update Date | 2011-12-12 |