| NPI | 1043357973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW20002) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: SC 4635) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2025-06-13 |