| NPI | 1912055393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: TN LSW0000004157) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MS C5951) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2007-07-09 |