| NPI | 1558645341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW11627) |
| Additional Taxonomies | 1041S0200X Social Worker, School |
| Enumeration Date | 2011-09-28 |
| Last Update Date | 2013-10-07 |