| NPI | 1023587003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: OH s.0800778) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OH s.00778) |
| Enumeration Date | 2018-11-19 |
| Last Update Date | 2018-11-19 |