| NPI | 1164433819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL SW10077) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2025-08-02 |