| NPI | 1437894300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA MSW010956) |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2022-05-04 |
| Last Update Date | 2026-02-27 |