| NPI | 1033388467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KS LSCSW4773) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WA LW60580943) |
| Enumeration Date | 2008-02-29 |
| Last Update Date | 2024-05-29 |