| NPI | 1336408533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AR 8667-C) |
| Additional Taxonomies | 104100000X Social Worker |
| 104100000X Social Worker (Licence: AR 8667-M) | |
| Enumeration Date | 2012-05-08 |
| Last Update Date | 2020-11-23 |