| NPI | 1780984609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: ID LMSW-26140) |
| Additional Taxonomies | 104100000X Social Worker (Licence: ID LCSW-35197) |
| Enumeration Date | 2010-10-26 |
| Last Update Date | 2020-06-11 |