| NPI | 1326729013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC P015082) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: ND P015082) |
| Enumeration Date | 2023-07-26 |
| Last Update Date | 2023-07-26 |