| NPI | 1316262009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NV 5772-C) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MT 923) |
| Enumeration Date | 2010-04-06 |
| Last Update Date | 2023-08-03 |