| NPI | 1245523836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NV 9299-C) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MT BBH-LCSW-LIC-38823) |
| Enumeration Date | 2011-05-16 |
| Last Update Date | 2025-03-05 |