| NPI | 1841553286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AR 6653-C) |
| Additional Taxonomies | 1041S0200X Social Worker, School (Licence: AR PROVISIONAL (PLMSW)) |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2018-09-07 |