| NPI | 1144549908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I1101198) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH S.0900855) |
| Enumeration Date | 2010-05-19 |
| Last Update Date | 2012-02-17 |