| NPI | 1003822081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NV IC-544) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NV IC-544) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2010-01-12 |