| NPI | 1174787782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NV 9215-C) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: PA CW017595) |
| 1041C0700X Social Worker, Clinical (Licence: IN 34005577A) | |
| Enumeration Date | 2008-07-12 |
| Last Update Date | 2022-03-30 |