| NPI | 1437352374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NV 4316-C) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: AZ LCSW-11768) |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2007-07-08 |