| NPI | 1336756998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH S.2106208) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OH S.2001513-TRNE) |
| Enumeration Date | 2020-09-28 |
| Last Update Date | 2021-07-29 |