| NPI | 1114572443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NV IC-2301) |
| Additional Taxonomies | 225C00000X Rehabilitation Counselor |
| Enumeration Date | 2019-08-04 |
| Last Update Date | 2023-10-06 |