| NPI | 1356356000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TN 5694) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: HI 3261) |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2018-09-07 |