| NPI | 1376720342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH LISW-I 3362) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IN 34001969) |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2008-01-22 |