| NPI | 1902169824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: PA CW018611) |
| Additional Taxonomies | 104100000X Social Worker (Licence: PA SW129761) |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2015-12-09 |