| NPI | 1417303124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NV 8568-C) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NV IC-1002) |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2025-07-28 |