| NPI | 1861761447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: DC LG101700) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MD 13885) |
| Enumeration Date | 2011-12-27 |
| Last Update Date | 2011-12-27 |