| NPI | 1740273655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NE 230) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NE 852) |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2007-07-08 |