| NPI | 1275913030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NV 7998-C) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NV 7064-S) |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2021-08-13 |