| NPI | 1225442437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.1800770) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OH S.1450279) |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2018-07-10 |