| NPI | 1295031771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW006681) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 133693) |
| 1041C0700X Social Worker, Clinical (Licence: FL TPSW3568) | |
| Enumeration Date | 2011-02-01 |
| Last Update Date | 2026-03-18 |