| NPI | 1427091107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW00005045) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WA LW5045) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2024-12-02 |