| NPI | 1871805366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KS 1934) |
| Additional Taxonomies | 104100000X Social Worker (Licence: KS 7750) |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2010-07-13 |