| NPI | 1992155253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 104100000X Social Worker (Licence: NV 7235-s) |
| Enumeration Date | 2016-06-17 |
| Last Update Date | 2016-06-17 |