| NPI | 1437673449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 405300000X Prevention Professional (Licence: PR 31104991) |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2022-07-21 |