| NPI | 1144810425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.2305065) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH S.2005662) |
| Enumeration Date | 2021-01-21 |
| Last Update Date | 2024-01-08 |