| NPI | 1265589279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW7727) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC C019310) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2026-01-29 |