| NPI | 1184362790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 104100000X Social Worker |
| 104100000X Social Worker | |
| Enumeration Date | 2022-05-24 |
| Last Update Date | 2022-05-24 |