| NPI | 1184696304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: AZ lcsw0394) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2013-09-17 |