| NPI | 1215179544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH s.0600413) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH s.0600413) |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2023-12-26 |