| NPI | 1043274764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.0003609) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH 3609) |
| 1041C0700X Social Worker, Clinical (Licence: FL SW 9067) | |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2024-11-04 |