| NPI | 1164476461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I. 0000618) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OH I000618) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2020-02-14 |