| NPI | 1811431232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: VA 0903002309) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 077504-1) |
| Enumeration Date | 2016-12-05 |
| Last Update Date | 2016-12-05 |