| NPI | 1427472687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.2102649) |
| Additional Taxonomies | 1041S0200X Social Worker, School (Licence: OH S.0031909) |
| Enumeration Date | 2014-02-08 |
| Last Update Date | 2021-10-16 |