| NPI | 1871868356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MD 12789) |
| Additional Taxonomies | 104100000X Social Worker (Licence: DC LC50078552) |
| Enumeration Date | 2012-03-15 |
| Last Update Date | 2012-03-15 |