| NPI | 1659478469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: NH 767) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: NH 767) |
| 104100000X Social Worker (Licence: MA 113652) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2009-01-22 |