| NPI | 1346351392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW15756) |
| Additional Taxonomies | 104100000X Social Worker (Licence: SC 006508) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-02-05 |