| NPI | 1093468670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW008300) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: GA MSW004734) |
| Enumeration Date | 2022-02-02 |
| Last Update Date | 2022-11-08 |