| NPI | 1396333761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 9388) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MO 2015044261) |
| Enumeration Date | 2021-01-01 |
| Last Update Date | 2023-10-26 |