| NPI | 1417200767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NV 11385-C) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NV IC-1930) |
| 104100000X Social Worker (Licence: NV 9426-M) | |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2024-03-26 |