| NPI | 1306477419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH i.2203944) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OH s.2004647) |
| Enumeration Date | 2020-01-28 |
| Last Update Date | 2022-11-11 |