| NPI | 1073060307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NH 2337) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MA 223813) |
| 104100000X Social Worker | |
| Enumeration Date | 2016-09-02 |
| Last Update Date | 2021-10-13 |