| NPI | 1033887005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH S.2101694-TRNE) |
| Enumeration Date | 2021-09-02 |
| Last Update Date | 2024-03-21 |