| NPI | 1285026336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW008793) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: SC 15664) |
| 1041C0700X Social Worker, Clinical (Licence: NC C009312) | |
| Enumeration Date | 2015-02-26 |
| Last Update Date | 2024-02-22 |