| NPI | 1427560085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: DC LC50081509) |
| Additional Taxonomies | 104100000X Social Worker (Licence: DC LG50080757) |
| Enumeration Date | 2017-11-03 |
| Last Update Date | 2019-12-20 |