| NPI | 1346899952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW18309) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: GA MSW008674) |
| Enumeration Date | 2019-09-06 |
| Last Update Date | 2023-10-10 |