| NPI | 1023256930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 004431) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2009-01-30 |
| Last Update Date | 2024-09-12 |