| NPI | 1952585952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA MSW003137) |
| Additional Taxonomies | 104100000X Social Worker (Licence: GA MSW003137) |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2010-12-27 |