| NPI | 1689686990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: VA 0904005414) |
| Additional Taxonomies | 104100000X Social Worker (Licence: DC LC3000848) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2019-05-16 |