| NPI | 1346815677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: DE Q1-0012348) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: PA CW023997) |
| Enumeration Date | 2021-05-20 |
| Last Update Date | 2025-10-08 |