| NPI | 1013118918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW4463) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OK 3403) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2017-10-26 |