| NPI | 1093423287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: SC 15376) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2022-11-07 |
| Last Update Date | 2023-03-30 |