| NPI | 1306248901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 104100000X Social Worker (Licence: NV 1602760796) |
| Enumeration Date | 2014-09-25 |
| Last Update Date | 2023-01-31 |