| NPI | 1376729913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: TX 52925) |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2024-08-09 |