| NPI | 1043863830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NV 9468-C) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NV IC-1415) |
| Enumeration Date | 2019-07-20 |
| Last Update Date | 2025-10-22 |