| NPI | 1336989219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: HI 5518) |
| Additional Taxonomies | 104100000X Social Worker (Licence: HI 2440) |
| Enumeration Date | 2024-05-29 |
| Last Update Date | 2026-05-08 |