| NPI | 1013072008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW21441) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NH 1071) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2023-07-14 |