| NPI | 1083733711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA SA70069051) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 104100000X Social Worker (Licence: SA70069051) | |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2026-04-02 |