| NPI | 1194202531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AR 8936C) |
| Additional Taxonomies | 104100000X Social Worker (Licence: AR 8936-M) |
| Enumeration Date | 2018-07-27 |
| Last Update Date | 2020-10-22 |